Medical specialty drug resources

In support of our mission to provide access to quality, affordable care for our members, Blue Shield has adopted solutions that partner with our providers to meet our member’s health care needs. The following resources are applicable for drugs covered under the medical benefit, including injectables and office-administered medications.

 

Medication drop ship program

For California providers participating in Blue Shield commercial PPO plans, including Individual & Family Plans (IFP), we offer a drop ship medication program as an alternative option to the buy-and-bill model of drug procurement.

View medication and drop ship pharmacies list (PDF, 380 KB)
Read about order triage services with ASPN Pharmacies (PDF, 84 KB)
Download a flyer (PDF, 230 KB)

 

Home infusion

Home infusion provides a safe and more convenient option for members who receive certain infusion medications. If you are considering home infusion for a member, use this patient-friendly flyer to help guide your discussion on the benefits of home infusion.

Download a home infusion flyer for HMO patients (PDF, 27 KB)
Read about order triage services with ASPN Pharmacies (PDF, 157 KB)

 

Site of service program

Blue Shield may direct commercial plan members with prescriptions for medication infusion therapy services in an outpatient hospital setting to qualified, home infusion, non-facility-owned infusion centers or physician offices.

View site of service medication list (PDF, 416 KB)

 

ASPN Pharmacies triage services for drop ship and home infusion

ASPN Pharmacies (ASPN) can help streamline the provider experience by reducing your office’s administrative burden. ASPN offers coordination services for drug procurement and prescription fulfillment of medication drop ship for PPO providers and home infusion orders for both HMO and PPO providers.

Order and fulfillment status updates are available through the ASPN web portal at aspnpharmacies.com/aspn. Log in to see drop ship and home infusion orders, at a glance.

Read frequently asked questions (PDF, 157 KB)
Download a flyer (PDF, 27 KB)

 

Preferred specialty drug list

Blue Shield has identified preferred drugs for certain therapeutic conditions, where clinically appropriate. This list includes preferences for biosimilar medication.

View preferred specialty drug list (PDF, 60 KB)

Biosimilar e-Learning module

Take an interactive module to learn about biosimilars and review the advantages of biosimilars.

View module

Medication policy

Read about our medication policy for injectable and office-administered drugs.

View medication policy

Online pharmacy authorization request

 pharmacy authorization request for Blue Shield IFP, Small, Large Group and Medicare member online via AuthAccel.

Request pharmacy authorization

Medication claims policies and guidelines

Learn about submitting claims and rules for payment, including Richman Injectables and CAR-T drugs.

Learn more

Provider manuals

Review reference procedure manuals and benefit guidelines.

View provider manuals

Ancillary provider rosters

Get a listing of Blue Shield contracted providers for ambulance, home health, medical equipment, home infusion, nursing, dialysis and other services.

Get rosters by provider type

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